A Retrospective Case Series Comparing the Incidence of Postoperative Hypotony Following Baerveldt Glaucoma Implant Surgery in Uveitic versus Non-Uveitic Glaucoma

Abstract

Purpose:: To evaluate the incidence of postoperative hypotony in glaucomatous eyes undergoing Baerveldt Glaucoma Implant (BGI) Surgery with a history of uveitis compared to a similar group of eyes with no history of uveitic glaucoma.

Design:: Retrospective comparative case series.

Participants:: Thirty-two eyes of 27 patients who underwent implantation of BGI devices between 2003 and 2005 at one institution for the treatment of glaucoma refractory to medical therapy.Intervention: Implantation of Baerveldt Glaucoma Drainage Device.

Methods:: Patients having undergone BGI surgery were identified using the surgeon’s log of procedures performed between 1 Jan 2003 and 31 DEC 2005. Pertinent preoperative and postoperative data was collected by reviewing the surgeon’s shadow files of each patient’s medical records. Data was analyzed using Fisher’s exact test (two-tailed).

Results:: Between 1 JAN 2003 and 31 DEC 2005, Baerveldt Glaucoma Implant (BGI) surgery was performed on 32 eyes of 27 patients at one institution by a single glaucoma surgeon. Thirteen of the 32 surgeries were performed on eyes with a history of uveitic glaucoma. The remaining 19 BGI operations were performed on eyes with no history of uveitis.The uveitic group was compared to the non-uveitic group. The two groups were comparable in median age (57 years in the uveitic group and 51 years in the non-uveitic group); preoperative intraocular pressure (36 mmHg in the uveitic group and 30 mmHg in the non-uveitic group); and systemic medical diseases. In the uveitic group, 10 of the 13 eyes (77%) had documented hypotony at some point in the postoperative course compared to 1 of the 19 eyes (5%) in the non-uveitic group (P<0.0001).

Main Outcome Measures:: Incidence of hypotony (IOP < 5 mmHg) in the postoperative period (4 weeks to 1 year following surgery)

Conclusions:: This retrospective case series suggests that hypotony is more common following BGI surgery in uveitic eyes, which should provide clinical information for operative and postoperative management as well as preoperative planning in patients with uveitic glaucoma. The data we report shows a higher incidence of postoperative hypotony in uveitic eyes than previous reports in the literature.

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • intraocular pressure • inflammation